| Name: ____________________________________________
Birthdate: ______________ Experience: ____________
T-Shirt Size: YL AS AM AL AXL
Address: _________________________________________
City: ________________ State: _______ Zip: _______
Phone (H): ___________ Phone (C/W): ______________
Parents Name: ____________________________________
EMail: ___________________________________________
Club Affiliation: ________________________________
Please choose which camp your child would like to attend: Week 1 2 Both
Elite QB School: Session 1 Session 2
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